Surgical sutures are well known medical devices used by physicians and surgeons in a variety of conventional surgical procedures and for various applications, including the approximation of tissue about wounds, securing other medical devices such as heart valves or catheters to tissue, connecting blood vessels, ligating blood vessels, approximating soft tissue and bone, etc. The sutures are typically attached on one or both ends to conventional surgical needles. The surgical needles are used to pierce and penetrate tissue and create a pathway in the tissue for the suture to pass through. In a typical surgical procedure, numerous passes of the needle and suture through tissue about the wound are often needed for complete tissue approximation. In order to properly secure the suture in tissue, it is necessary to knot the ends of the suture so that, subsequent to the procedure, when the approximated tissue pulls on the suture it will remain substantially in place. This is critical for the healing process.
Relatively recently, minimally invasive surgical procedures have been introduced and have replaced many conventional, open procedures. Examples of minimally invasive procedures include cholecystectomies, appendectomies, arthroscopic repairs to joints, laparoscopic surgery, microsurgery, and thoracoscopic surgery. In a conventional minimally invasive procedure, the surgical site is accessed with trocar to emplace trocar cannulas. The trocar cannulas provide a relatively small opening and pathway to the surgical site. The size of such openings is dependent upon the nature of the procedure and the characteristics of the surgical site, may typically range, for example, from 5 mm to 12 mm. The trocar cannulas provide pathways to and from the surgical site for surgical instruments, and for scopes to provide the surgeon with a remote image of the site. Specially designed endoscopic, laparoscopic or arthroscopic instruments are used in such minimally invasive procedures. The instruments typically have elongated shafts with the operable functional instrument members on the distal ends, which are controllable by a handle or controller on the proximal end. It is necessary that the shaft and the distal working end, or so-called “business end”, have small profiles in order to readily fit through a cannula and access the surgical site, and to provide for maneuverability by the surgeon during the procedure.
One difficulty encountered in minimally invasive surgical procedures is approximating tissue at the surgical site using surgical needles and sutures. This has been addressed by special endoscopic suture instruments which allow the surgeon to pass surgical needles through tissue while working through cannulas and viewing the site remotely on a visual display. This is often a difficult and time-consuming procedure even with these specially designed instruments, and the knotting or securing of the suture after the tissue approximation has been completed has been especially challenging. It would be advantageous to have sutures that could be secured in a minimally invasive procedure without the need for the surgeon to tie knots.
Accordingly, there is a need in this art for novel surgical sutures useful in minimally invasive surgical procedures having the capability of being readily secured in tissue without the need for tying surgical knots after emplacement in tissue.